Kimberley Quinlan, MFT, of the OCD Center of Los Angeles discusses the diagnostic overlap between OCD and eating disorders.  Part one of a two-part series.

OCD and Eating Disorders

It can sometimes be difficult to differentiate between the symptoms of OCD and those of an eating disorder.

I was recently asked by a client if there was any functional difference between eating disorders and Obsessive Compulsive Disorder (OCD). After all, if OCD is defined as experiencing obsessive thoughts and compulsive behaviors, wouldn’t an eating disorder be categorized in the same way, given that those with eating disorders have obsessive thoughts about their weight and appearance, and respond to these thoughts with compulsive behaviors?

When looked at along these lines, it is obvious that OCD and eating disorders indeed have many similarities.  But it is important to consider certain distinctions between these conditions before formulating a diagnosis.

To provide a better understanding of OCD and both its differences and similarities with eating disorders, clinicians rely upon specific diagnostic criteria.  Recently, the American Psychiatric Association (APA) refined these criteria in the newly published Diagnostic and Statistical Manual (fifth edition), also known as the DSM-5.  This manual is used by clinicians to differentiate between various psychological conditions, thus assisting in the development and implementation of appropriate treatment.

Read More »

    

The impact of OCD and related anxiety based disorders on the family is often overlooked.  In this multi-part series, we present first-hand accounts of the ongoing impact of OCD, BDD, and Bipolar Disorder on one man and his family, as told to Elizabeth Kassel, MSW, of the OCD Center of Los Angeles.

Life with OCD

Those suffering with OCD need
understanding and treatment

My name is Robert and I have Obsessive-Compulsive Disorder (OCD).  I am a thirty-four year old, single man and work as a personal fitness trainer. My story is not typical, but it is the only one I have . . .

I was four years old when I looked at a picture Bible and saw an image of Satan. My thought was, “Satan is cool!” He wore a red cape and was “ripped!”  My obsession was that, since I thought he was cool, I was evil and I would go to hell. I knew that evil people hurt others, and I was terrified of hurting someone. It never occurred to me to tell my parents. I figured all kids thought this way too, but the other kids just seemed to be “managing” it better than I was. They didn’t appear bothered by the eternal consequences of their actions like I was. They were talking back, swearing, being disrespectful and acting cocky, but weren’t worried about going to hell. I figured that thinking Satan was cool and that I was evil was “normal”, and that I just had to be more laid back and figure out how to worry less.

One day when I was fourteen, I had an intrusive thought that I wasn’t funny. I couldn’t shake it and kept a journal of funny quips so I could be “funny” in social situations. I tried to keep up the compulsion of memorizing stuff from the “funny book” so I wouldn’t be “slow”. I wanted to be quick witted, playful and charming.  The irony is people said I was funny – I just didn’t “feel” like I was.  I fought to I remember “my lines” to get rid of the anxiety. At about the same age, I had the obsession that my penis wasn’t the right size. I was pre-pubescent and a “late bloomer.” When in the locker room at school, I compared the boys’ penises to my dad’s penis and thought, ”Wow! They’re tiny!” I even asked my mom one day, “Does size matter?”

Read More »

    

Skin Picking Disorder (Dermatillomania)

Cognitive Behavioral Therapy (CBT) is the most effective treatment for Skin Picking Disorder (Dermatillomania)

In our previous article on Skin Picking Disorder (also known as Dermatillomania or Excoriation),  we wrote about a classification system for skin picking. Let’s review “The ABC’s of Skin Picking”:

An “A” is something that almost anyone would pick. This could be a piece of dry skin hanging off your arm, a pus-filled whitehead on your chin that pops at your mere touch, or a scab that’s barely hanging on which you can easily detach.

A “B” is a “bump”, pimple, scab, etc. that only a skin picker would pick, frequently causing it to bleed, ooze, scab, and possibly become infected. This in turn will cause two additional problems – it will cause the picker significant distress, and it will give him or her something new to pick at later. In our experience, clients with Dermatillomania classify at least 50% of their picking as “B’s”. Read More »

    

Body Dysmorphic Disorder (BDD) is a condition in which one has an obsessive preoccupation with his or her physical appearance. We recently posted two articles about the condition, one on BDD in the media, and the other on BDD in teenagers.  In the final installment of our three part series, we look at recent research related to this condition.

Body Dysmorphic Disorder and How We See Ourselves

BDD - Body Dysmorphic Disorder

Researchers are learning more about
Body Dysmorphic Disorder (BDD).

This past year saw a number of interesting research studies on the topic of body image and Body Dysmorphic Disorder (BDD).  One study surveyed over 2200 men and women of various body types regarding their self-perceptions related to weight and body image.  Those who completed the survey were evaluated for their body-mass index (BMI), a ratio of height to weight that provides a range of numerical values for what could be described as a “healthy weight”.  Participants were also instructed to describe how they perceived their bodies, using a range of terms such as “slim” and “fat”.

The study found that only 13% of the women participants who were evaluated as having a “healthy” weight for their height (BMI) were satisfied with their overall appearance.  More disturbing was the finding that only 6% of these women saw themselves as being “slim”.  Conversely, only 6% of the male participants who were evaluated as having a healthy BMI saw themselves as “fat”.  Furthermore, of the study participants who were actually overweight, twice as many women as men described themselves as being “ashamed” of their bodies.  The most obvious conclusion we can draw from these data is that men and women see themselves in startlingly different ways, and have very different emotional reactions to their weight.

Read More »

    

Binge Eating / Compulsive Overeating

Binge Eating / Compulsive Overeating is a
real problem that can be successfully treated.

Binge Eating Disorder, also known as ‘”compulsive overeating”, can perhaps best be described as a condition in which one periodically consumes extremely large amounts of food.   Individuals with Binge Eating Disorder have a strong motivational drive for food and experience great difficulty in their attempts to restrain their eating.   They frequently continue eating well beyond their satiation level, with many reporting that their behavior feels “unconscious”, and that they have little control over it.  It appears that compulsive overeating is often done in response to emotional difficulties or psychosocial stressors.  Unfortunately, during and after a binge, one is often left feeling more depressed, anxious and helpless than they did before they overate.

In addition to the psychological issues noted above, some researchers and theoreticians believe that compulsive overeating has played a significant role in the dramatic increase in obesity levels in the United States over the past 30 years.  Obesity is commonly identified as having a body-mass index (BMI) over 30.  Using this guideline, approximately 34% of Americans are currently classified as obese, compared to 15% in 1980.  During this same 30 year period, this increase in obesity has led to a concomitant surge in diabetes and hypertension, both of which are risk-factors for heart disease, the number one cause of death in the US.

Read More »

    

Increasing numbers of teens are having elective cosmetic surgeries to address body image issues, without fully considering the physical and psychological risks involved. Part two of our three-part series on Body Dysmorphic Disorder (BDD).

BDD - Body Dysmorphic Disorder

Teens are increasingly seeking cosmetic surgery

Our last post focused on Body Dysmorphic Disorder (BDD), body image issues, and cosmetic surgery in the entertainment industry.  While I can appreciate that movie stars and models to some extent depend on their appearance for their livelihoods, I worry about the message that stars’ cosmetic surgeries send to the public, particularly young women who see these stars as role models.  One recent news story focused on the increasing numbers of teens seeking cosmetic surgeries.  The article noted three problematic issues specifically related to this growing trend of teens looking to surgically enhance their bodies:

  • Teens’ bodies are still changing and growing, so having surgeries before their bodies have fully grown is ill-advised;
  • Teens seeking cosmetic surgeries may be suffering from depression and would be better advised to address their feelings about themselves in a non-surgical manner
  • Teens often don’t understand the significant risks involved in having any surgery, including the risk of disfigurement and death.

On this last note, readers should be reminded that people can and do die as a result of complications from what are considered “routine” cosmetic surgeries.  Many will remember the publicity generated by the November 2007 death of Kanye West’s mother from complications related to having a tummy tuck and breast augmentation.  In fact, many people die each year following cosmetic procedures.  One recent study found the mortality rate for those undergoing liposuction was approximately one death for every 5000 patients, while approximately one out of every 350 patients undergoing this supposedly “routine” procedure experienced “significant complications”.

Read More »

    

In late 2008, the drug Lumigan, originally developed to treat glaucoma, was approved by the Food and Drug Administration (FDA) to be prescribed as an eyelash enhancer.  It seems that one of the side effects of the glaucoma drug, now called Latisse when marketed for eyelash enhancement, is eyelash growth.  According to a recent article in the Los Angeles Times, Latisse is being prescribed by dermatologists, plastic surgeons, and day spa physicians to women who want to increase the length and fullness of their lashes.

Is this a good thing?  One of the most common issues we see in our clients with Body Dysmorphic Disorder (BDD) is excessive focus on the appearance of their eyes, including their eyelashes.  Latisse plays right into this common BDD concern. Read More »

  • OCD is Fake News

    OCD is just fake news that your brain makes up. From the OCD Center of Los Angeles. Helping clients in California and around the world since 1999.

  • HOCD: 30 Things You Need To Know

    HOCD is a type of OCD in which the individual obsesses about their sexual orientation. Here are 30 things you should know about HOCD. From the OCD Center of Los Angeles.

  • Doubt, Denial and OCD

    A discussion of “The Denial Obsession” in OCD, in which sufferers obsess that they don’t really have OCD, but are merely “in denial”. By Lauren McMeikan, MA, and Tom Corboy, MFT, of the OCD Center of Los Angeles.

  • Dermatillomania: A Skin Picker’s Guide to the Dermatologist

    How one woman with Dermatillomania finally opened up to her dermatologist about her longtime struggle with skin picking.

  • Imaginal Exposure for OCD and Anxiety

    Imaginal exposure for the treatment of OCD and anxiety is discussed by Tom Corboy, MFT, of the OCD Center of Los Angeles.

  • ROCD: Relationship OCD and The Myth of “The One”

    ROCD (Relationship OCD) is an often misunderstood variant of OCD. By Sheva Rajaee, MMFT and Tom Corboy, MFT of the OCD Center of Los Angeles.

  • Moral Scrupulosity in OCD: Cognitive Distortions

    Cognitive distortions are common in the Moral Scrupulosity subtype of OCD. Part three of a multi-part series.

  • OCD in the Family

    One mom’s story of her son’s battle with OCD and its profound impact on their family, as told to Elizabeth Kassel, MSW, of the OCD Center of Los Angeles.

  • Scrupulosity in OCD: Cognitive Distortions

    A discussion of cognitive distortions in the religious Scrupulosity subtype of OCD. Part two of a multi-part series.

  • OCD and Eating Disorders

    Diagnostic similarities and differences between OCD and eating disorders are discussed by Kimberley Quinlan, MFT, Clinical Director of the OCD Center of Los Angeles.

  • Harm OCD Treatment With ERP

    Harm OCD treatment using Exposure and Response Prevention (ERP) is discussed by Tom Corboy, MFT, Executive Director of the OCD Center of Los Angeles .

  • My Life with OCD

    The impact of OCD and related anxiety based disorders on the family is often overlooked. In this multi-part series, we present first-hand accounts of the ongoing impact of OCD, BDD, and Bipolar Disorder on one man and his family, as told to Elizabeth Kassel, MSW, of the OCD Center of Los Angeles.

  • Scrupulosity: Where OCD Meets Religion, Faith, and Belief

    The Scrupulosity sub-type of OCD is discussed by Kevin Foss, MFT, of the OCD Center of Los Angeles. Part one of a four part series.

  • Mindfulness for OCD and Anxiety

    Using mindfulness to enhance traditional CBT for OCD and anxiety is discussed by Kimberley Quinlan, MFT, Clinical Director of the OCD Center of Los Angeles.

  • Hoarding, Cluttering, and Compulsive Shopping: My Childhood Story

    One woman’s story of her life as the child of multiple generations of hoarders.

  • OCD and Thought-Action Fusion

    Thought-Action Fusion is a frequent problem for those with OCD. This issue is discussed by Laura Yocum, MFT, of the OCD Center of Los Angeles.

  • OCD, Anxiety, and Resistance

    Resistance and acceptance in OCD and related disorders is discussed by the OCD Center of Los Angeles.

  • Harm OCD Treatment: Cognitive Restructuring

    Harm OCD is often misunderstood, but it can be effectively treated using an integrated treatment plan that includes Cognitive Restructuring. Part three of our ongoing series that explores “Harm OCD” and its treatment .

  • OCD & Anxiety: Five Common Roadblocks to Treatment

    Learn the five common mistakes that interfere with successful treatment of OCD and anxiety. By Kimberley Quinlan, MFT, Clinical Director of the OCD Center of Los Angeles.

  • Harm OCD Treatment: Mindfulness Based CBT

    Harm OCD is an often misunderstood condition that can be effectively treated using Mindfulness integrated with CBT. Part two of a multi-part series from the OCD Center of Los Angeles.

 

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